I’m entering a few months prep for the UK and Ireland exit exam in Emergency Medicine: the FRCEM. I’ll be adding lots of little notes on pearls I’ve learned along the way. A lot of my revision is based around the Handbook of EM as a curriculum guide and review of contemporary, mainly UK guidelines. I also focus on the areas that I’m a bit sketchy on. With that in mind I hope they’re useful.
You can find more things on the FRCEM on this site here.
From NICE 2013
What are some risk factors for AKI?
by no means exhaustive
- CKD
- heart failure
- liver disease
- DM
- history of AKI
- reduced urine output
- nephrotoxic drugs and contrast
- sepsis
- age>65
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how is it graded?
- NICE mentions the RIFLE, AKIN and KDIGO systems without adhering to one
- it does give these criteria
- inc creatinine by 26 in 48 hrs
- 50% rise in creatinine in 7 days
- <0.5ml/kg/hr urine for 6 hrs for adults and 8 hrs for kids
- 25% reduction in eGFR in 7 days
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how is it investigated?
- most of this is clinically guided
- they make specific recommendations on ultrasound
- within 24 hrs if no obvious cause found clinically
- within 6 hrs if obstructed infection suspected (eg a stone and sepsis)
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how is it treated?
- treat cause of course
- some specific comments on diuretics
- considered in fluid overload awaiting dialysis
- considered in fluid overload while renal function recovering
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what are the RIFLE criteria?
because no chance i’m remembering more than one
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